Provider Demographics
NPI:1104516053
Name:COMPASS RECOVERY WEST, LLC
Entity type:Organization
Organization Name:COMPASS RECOVERY WEST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DINO
Authorized Official - Middle Name:
Authorized Official - Last Name:BEDINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LADC
Authorized Official - Phone:413-207-4307
Mailing Address - Street 1:117 PARK AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3363
Mailing Address - Country:US
Mailing Address - Phone:413-861-0680
Mailing Address - Fax:
Practice Address - Street 1:117 PARK AVE STE 303
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3363
Practice Address - Country:US
Practice Address - Phone:413-861-0680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility